瘦素与急性脑卒中相关关系的研究

A STUDY ON RELATIONSHIP BETWEEN LEPTIN AND ACUTE STROKE

目的通过测定脑卒中病人血清瘦素水平的变化,分析瘦素与胰岛素抵抗、血压和血脂之间的相关性,探讨瘦素与脑卒中的关系。方法选取127例发病48 h以内的急性脑卒中病人（脑出血组65例,脑梗死组62例）及健康自愿者60例（对照组）。测量血压、空腹血糖（FPG）、血脂指标;用放免分析法检测瘦素及空腹胰岛素（FINS）水平,计算胰岛素敏感指数（ISI）。结果急性脑梗死和脑出血组血清瘦素、高密度脂蛋白（HDL-C）、FINS、ISI、收缩压和舒张压与对照组比较,差异均有显著性（t=1.993～20.588,P〈0.05）。脑出血组血清胆固醇（TC）和FPG与对照组比较差异有显著性（t=3.597、4.286,P〈0.05）。脑出血病人血清瘦素与FPG、FINS、血压呈正相关（r=0.38～0.56,P〈0.05）,与HDL-C呈负相关（r=-0.38,P〈0.01）。脑梗死病人血清瘦素与FINS呈正相关（r=0.36,P〈0.05）,与HDL-C呈负相关（r=-0.31,P〈0.05）。结论高瘦素血症、胰岛素抵抗是脑卒中的危险因素。血清瘦素水平升高则ISI降低,胰岛素抵抗加重。瘦素可能加重脑卒中病人脂质代谢紊乱。

Objective To explore the relationship between leptin level and insulin resistance, blood pressure and blood lipid in acute stroke. Methods This study consisted of 127 patients admitted within 48 hours after the onset of stroke, including 65 hemorrhagic stroke and 62 ischemic stroke. Sixty healthy subjects served as controls. Blood pressure was taken. Leptin and fasting insulin （FINS） were detected using radioimmunoassay technique. Fasting plasma glucose （FPG）, triglyceride （TG）, total cholesterol （TC）, LDL and HDL were detected. Insulin sensitivity index （ISI） was calculated by formula （In [1/FPG/Fins]）. Results There were significant differences between the patients and the controls in the levels of leptin, HDL-C, FINS and ISI （t= 1. 993-20. 588,P〈0.05）. The levels of TC and FPG in hemorrhagic stroke were higher than those in the controls （t= 3. 597, 4. 286;P〈0.05）. The leptin level in the hemorrhagic was related positively to FPG, FINS and FPG, and it was related negatively to HDL-C. The leptin in the ischemie was related positively to FINS, and it was related negatively to HDL-C serum leptin and insulin resistance are risk factors for stroke. The high leptin is always along with low ISI and tance. The leptin may aggravate metabolic disorder of lipid in stroke.